Abstract:
OBJECTIVE:To determine the effects of orthostatic hypotension (OH) measurement timing on its associations with dizziness, falls, fractures, cardiovascular disease (CVD), and mortality. METHODS:We analyzed OH measurements from the Action to Control Cardiovascular Risk in Diabetes BP trial, which evaluated two blood pressure (BP) goals (systolic BP [SBP] < 120 mm Hg vs. SBP < 140 mm Hg) and incident CVD among adults with diabetes and hypertension. Seated BP was measured after 5 minutes of rest at baseline and follow-up visits (12 months, 48 months, and exit). Standing BP was measured 3 consecutive times (M1-M3) after standing, starting at 1 minute with each measurement separated by 1 minute. Consensus OH was defined as a drop in SBP ≥ 20 mm Hg or diastolic BP (DBP) ≥ 10 mm Hg. Participants were asked about orthostatic dizziness, recent falls, and recent fractures, and underwent surveillance for CVD events and all-cause mortality. RESULTS:There were 4,268 participants with OH assessments over 8,450 visits (mean age 62.6 years [SD = 6.6]; 46.6% female; 22.3% black). Although all measures of consensus OH were significantly associated with dizziness, none were associated with falls, and only M2 (~3 minutes) was significantly associated with fractures. No measurements were associated with CVD events, but later measurements were significantly associated with mortality. BP treatment goal did not increase risk of OH regardless of timing. Associations were not consistently improved by the mean or minimum of M1-M3. CONCLUSION:In this population of adults with hypertension and diabetes, neither single time nor set of measurements were clearly superior with regard to outcomes. These findings support the use of a flexibly timed, single measurement to assess OH in clinical practice. CLINICAL TRIALS REGISTRATION:Trial Number NCT00000620.
journal_name
Am J Hypertensjournal_title
American journal of hypertensionauthors
Juraschek SP,Lipsitz LA,Beach JL,Mukamal KJdoi
10.1093/ajh/hpz015subject
Has Abstractpub_date
2019-06-11 00:00:00pages
684-694issue
7eissn
0895-7061issn
1941-7225pii
5301692journal_volume
32pub_type
杂志文章abstract:BACKGROUND:Endothelial dysfunction and arterial stiffening are commonly observed in type 2 diabetes. These abnormalities might be secondary to increased plasma concentrations of homocysteine. We sought to determine whether oral folic acid supplementation, by lowering homocysteine levels, enhanced endothelial function a...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.amjhyper.2004.08.036
更新日期:2005-02-01 00:00:00
abstract::The effects of angiotensin converting enzyme (ACE) inhibitors on the release of angiotensin II (Ang II) from isolated mesenteric arteries of spontaneously hypertensive rats (SHRs) were examined. Delapril, enalapril, and captopril suppressed Ang II release in a dose-dependent manner. After oral treatment with delapril ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/4.1.56s
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:Carvedilol is known to be an adrenoreceptor blocker and free radical scavenger, used in hypertension and cardiac failure. However, its therapeutic actions cannot be fully explained by these mechanisms. In these studies, we tested the hypothesis that carvedilol action is associated with the synthesis/release ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.11.011
更新日期:2006-04-01 00:00:00
abstract:BACKGROUND:Different methods of normalizing left ventricular (LV) mass for body size identify generally similar relative risks of adverse cardiovascular outcome but with variable prevalences of LV hypertrophy (H). Preliminary results from a population with high prevalence of obesity suggest that the population attribut...
journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjhyper.2005.05.027
更新日期:2005-10-01 00:00:00
abstract::Renin secretion by the kidney is inhibited by an increase in free intracellular calcium concentration. This increase in free intracellular calcium content may be augmented by serum 1,25-dihydroxyvitamin D. In 10 subjects with high renin hypertension, an increase in dietary sodium intake resulted in an increase in urin...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/ajh/3.12.903
更新日期:1990-12-01 00:00:00
abstract:BACKGROUND:Low birth weight has been associated with increased risk of hypertension later in life. The aim of this study was to evaluate the association between birth weight and blood pressure (BP) in healthy 9- to 10-year-old Icelandic children. METHODS:Each child underwent 4 seated BP measurements, and the BP percen...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/hps012
更新日期:2013-01-01 00:00:00
abstract::The objective of this study was to test the relationship between neurologic and microvascular complications of type 1 diabetes mellitus. It was hypothesized that the mechanisms operative in autonomic dysfunction seen in diabetic patients with microangiopathy play a role in the rapidity of progression to renal failure....
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00472-x
更新日期:1998-03-01 00:00:00
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journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2008.27
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:The W allele of the G460W polymorphism in the adducin-1 gene has been occasionally associated with increased blood pressure (BP). The aim of this study was to test whether the G460W variant is associated with BP levels and BP progression rate and whether G460W associations with BP are affected by sex, body m...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2007.04.007
更新日期:2007-09-01 00:00:00
abstract:BACKGROUND:Hypertensive disorders of pregnancy, including preeclampsia (PE), affect approximately 7-10% of pregnancies in the US. Clinical and experimental studies strongly suggest that the maternal immune system plays a role in the development of these disorders; however, few therapeutic options exist aside from deliv...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2009.125
更新日期:2009-10-01 00:00:00
abstract::High dietary Na+ raises mean arterial pressure (MAP) by more than 10% in salt-sensitive (SS) patients with essential hypertension. To test whether the rise in MAP in these patients is caused by a Na(+)-linked increase in [Ca2+]i in vascular smooth muscle cells, we measured [Ca2+]i in the lymphocytes of 14 patients wit...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/5.8.536
更新日期:1992-08-01 00:00:00
abstract:BACKGROUND:A successful weight loss program is essential treatment for obesity-related diseases, but it is well known that the majority of individuals do not succeed in weight loss maintenance. The present study evaluates hormonal mechanisms and the relationship of beta2-adrenoceptor polymorphisms involved in individua...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.05.006
更新日期:2005-11-01 00:00:00
abstract::Previous studies showed that alpha 2-adrenergic receptors and imidazoline-guanidinium receptive sites (IGRS) are colocalized in rabbit and human renal proximal tubule. In the present study we investigated the localization of these two binding sites in the renal medulla from human kidney. Binding studies performed with...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/5.4.69s
更新日期:1992-04-01 00:00:00
abstract::Thromboembolic complications such as ischemic stroke and myocardial infarction are significantly more frequent in patients with arterial hypertension. From the available intervention studies, it appears that pharmacologic treatment of hypertension-at least with diuretics and beta-blockers-may more effectively protect ...
journal_title:American journal of hypertension
pub_type: 杂志文章,评审
doi:10.1016/s0895-7061(97)00496-2
更新日期:1998-03-01 00:00:00
abstract::In normal subjects, insulin decreases the urinary excretion of sodium, potassium, and uric acid. We tested whether these renal effects of insulin are altered in insulin resistant hypertension. In 37 patients with essential hypertension, we measured the changes in urinary excretion of sodium, potassium, and uric acid i...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/0895-7061(96)00098-2
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND:Family history of hypertension is a primary predictor of high blood pressure (BP). This study attempted to determine whether there is a gradual increase in BP between individuals with two hypertensive parents, one hypertensive parent, and normotensive parents and whether this increase is apparent with both a...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2005.09.025
更新日期:2006-05-01 00:00:00
abstract::Nonsteroidal anti-inflammatory drugs interfere with certain antihypertensive therapies. In a double-blind study, 385 hypertensive patients stabilized on an angiotensin converting enzyme inhibitor were treated with nabumetone, celecoxib, ibuprofen, or placebo for 4 weeks. Ibuprofen caused significantly greater increase...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1016/s0895-7061(02)03203-x
更新日期:2003-02-01 00:00:00
abstract::The results of ambulatory blood pressure monitoring (ABPM) in children after kidney transplant were analyzed to ascertain any alteration in circadian BP profile, degree of hypertension, and efficacy of therapy. The data were also compared with casual BP data and left ventricular mass index (LVMI). We have examined 30 ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(97)00484-6
更新日期:1998-04-01 00:00:00
abstract::The influence of increased lability of blood pressure on the development of aortic atherosclerosis was examined. Because sinoaortic denervation (SAD) produced increased lability of blood pressure without blood pressure elevation, the development of atheromatous plaque was examined in SAD rats. These rats were fed a hi...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1093/ajh/7.5.453
更新日期:1994-05-01 00:00:00
abstract::The Multicenter Isradipine/Diuretic Atherosclerosis Study (MIDAS) is a randomized, double-blind, active-control trial to compare the effectiveness of two treatment regimens for the control of hypertension in reducing the rate of progression of early extracranial carotid artery atherosclerosis in hypertensive patients....
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1093/ajh/4.2.114s
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:Aging is a major risk factor for the development of arterial stiffness and vascular disease, and it is related to the upregulation of matrix metalloproteinase-2 (MMP-2) in the aorta of rats and nonhuman primates. This study aimed to determine whether MMP activity in the human vasculature changes with aging. ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.11.011
更新日期:2005-04-01 00:00:00
abstract:BACKGROUND:Mice with targeted deletion of neuronal nitric oxide (NO) synthase (nNOS⁻(/)⁻) display inability to increase plasma renin concentration (PRC) in response to sodium restriction. nNOS has a distinct expression at the macula densa (MD), and in the present study, it was tested whether nNOS supports renin release...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.153
更新日期:2010-11-01 00:00:00
abstract::Insulin acutely inhibits contraction of primary cultured vascular smooth muscle (VSM) cells from canine femoral artery by inhibiting contractile agonist-induced Ca2+ influx. Insulin also inhibits contraction at step(s) distal to intracellular Ca2+ concentration (Ca2+i) by stimulating cyclic guanosine monophosphate (GM...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/s0895-7061(99)00239-3
更新日期:2000-04-01 00:00:00
abstract:BACKGROUND:Differences between the antihypertensive responses to drug therapy measured by office blood pressure (OBP) and ambulatory blood pressure monitoring (ABPM) techniques have been noted but rarely analyzed. We studied whether the OBP and 24-h ABPM responses to hydrochlorothiazide differ and, if so, the relevance...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1016/j.amjhyper.2004.10.021
更新日期:2005-03-01 00:00:00
abstract:BACKGROUND:Myocardial infarction (MI) is commonly associated with cardiac hypertrophy, reduced Ca²(+) uptake into the sarcoplasmic reticulum (SR) and impaired myocardial relaxation. Treatment to prevent MI-associated complications is currently lacking. The purpose of the present study was to investigate the remodeling ...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1038/ajh.2010.157
更新日期:2010-11-01 00:00:00
abstract::Patients with hypertension tend to be glucose intolerant, hyperinsulinemic, and dyslipedemic. Since all of these changes increase risk of coronary heart disease (CHD), it is important to know what effect antihypertensive treatment has on these variables. The current open-labelled, uncontrolled study was initiated in o...
journal_title:American journal of hypertension
pub_type: 临床试验,杂志文章
doi:10.1093/ajh/5.8.506
更新日期:1992-08-01 00:00:00
abstract:BACKGROUND:Nocturnal blood pressure (BP) is associated with risk for cardiovascular events. However, the relationship between nocturnal BP in young adults and cognitive function in midlife remains unclear. METHODS:We used data from the ambulatory BP monitoring substudy of the Coronary Artery Risk Development in Young ...
journal_title:American journal of hypertension
pub_type: 杂志文章,多中心研究
doi:10.1093/ajh/hpv028
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Sleep apnea is being studied as a risk factor for hypertension. This observational chart review was conducted to determine the long-term effects of continuous positive airway pressure (CPAP) treatment on blood pressure (BP) in a sample of sleep apnea patients from urban and rural populations. METHODS:This s...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/j.amjhyper.2004.11.031
更新日期:2005-05-01 00:00:00
abstract:BACKGROUND:Although a hypertensive response to exercise (HRE) is associated with cardiac risk and masked hypertension (MHT), its mechanisms and appropriate treatment remain unclear. We investigated spironolactone as a treatment for abnormal vascular and myocardial stiffness in HRE. METHODS:In this randomized, double-b...
journal_title:American journal of hypertension
pub_type: 杂志文章,随机对照试验
doi:10.1093/ajh/hpt008
更新日期:2013-05-01 00:00:00
abstract::The objective of the present study was to determine the relationship between plasma renin levels, and the development of hypertension and cardiac hypertrophy in TGR (mREN2)27 hypertensive rats. Systolic blood pressure and left ventricular mass index (LVMI) were measured in transgenic heterozygote and normotensive Spra...
journal_title:American journal of hypertension
pub_type: 杂志文章
doi:10.1016/0895-7061(95)00254-5
更新日期:1995-12-01 00:00:00